<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Dealer_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-dealer_id" data-rule="required" data-source="dealer/index" class="form-control selectpage" name="row[dealer_id]" type="text" value="{$row.dealer_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Firstratio')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-firstratio" class="form-control" name="row[firstratio]" type="number" value="{$row.firstratio|htmlentities}">
        </div>
    </div>
    <!--<div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Secondratio')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-secondratio" class="form-control" name="row[secondratio]" type="number" value="{$row.secondratio|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Thirdratio')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-thirdratio" class="form-control" name="row[thirdratio]" type="number" value="{$row.thirdratio|htmlentities}">
        </div>
    </div>-->
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
